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Gullet cancer

Gullet cancer – the malignant tumor which is formed from the expanded and regenerated gullet wall epithelium. Clinically cancer of a gullet is shown by the progressing disorders of swallowing and, as a result, decrease in body weight as a result of insufficient food. Originally, as a rule, find tumoral education at a X-ray analysis, an endoscopic research, KT or ultrasonography. The diagnosis - gullet cancer - is established after carrying out a histologic research of a bioptat of a new growth regarding detection of malignant cages.

    Gullet cancer

    Gullet cancer – the malignant tumor which is formed from the expanded and regenerated gullet wall epithelium. Clinically cancer of a gullet is shown by the progressing disorders of swallowing and, as a result, decrease in body weight as a result of insufficient food. Originally, as a rule, find tumoral education at a X-ray analysis, an endoscopic research, KT or ultrasonography. The diagnosis - gullet cancer - is established after carrying out a histologic research of a bioptat of a new growth regarding detection of malignant cages.

    As well as any malignant new growth, cancer of a gullet has especially the adverse forecast, than the disease is revealed later. Early detection of cancer promotes more expressed effect, tumors on 3-4 stages usually are not subject to full treatment. At germination by a cancer tumor of walls of a gullet are surprised surrounding fabrics of a sredosteniye, a trachea, bronchial tubes, large vessels, lymph nodes. The tumor is inclined to metastasis in lungs, a liver, can extend on a digestive tract in a stomach and intestines.

    Risk factors of development of cancer of gullet

       -  Now mechanisms of development of cancer of gullet are up to the end not studied. The factors promoting developing of a malignant tumor are: smoking, abuse of alcohol, the use is excessive more hotly and too cold food, production harm (inhalation of toxic gases), the content of heavy metals in drinking water, chemical burns of a gullet at a proglatyvaniye of caustic substances.

    Regular inhalation of the air containing a dust suspension of harmful substances (at accommodation in the smoke-filled area, work in not aired rooms with high concentration of production dust), can also promote development of cancer.

    The diseases promoting development of cancer of gullet is the gastroezofagealny disease, obesity, a keratodermiya. Gullet hernias, an akhloziya (relaxation of the lower sphincter of a gullet) promote a regular reflux – throwing of contents of a stomach in a gullet that in turn leads to development of a specific state: Barrett's diseases.

    Barret's disease (Barret's gullet) is characterized by regeneration of an epitelialny vystilka of a gullet as a gastric epithelium. This state is considered precancer, as well as by the majority of epitelialny displaziya (fabric development violations). It is noted that gullet cancer arises at persons more often 45 years are more senior, men suffer from it three times more often than women.

    Development of cancer is promoted by the food containing insufficient amount of vegetables, greens, protein, minerals and vitamins. Irregular food, tendency to an overeating also exert negative impact on gullet walls that can promote decrease in protective properties. One of factors of an ozlokachestvleniye of precancer educations is decrease in immunity.

    Classification of cancer of gullet

      ( )Cancer of a gullet is classified according to the international nomenclature of TNM for malignant new growths:

    • on a stage (T0 – a precancer, a carcinoma, a noninvasive epitelialny tumor, T1 – cancer strikes mucous, T2 - the tumor sprouts in a submucous layer, T3 – are struck layers up to muscular, T4 – penetration of a tumor through all layers of a wall of a gullet in surrounding fabrics);
    • on distribution of metastasises in regional lymph nodes (there is no N0 – metastasises, N1 – is metastasises);
    • on distribution of metastasises in the remote bodies (M1 – is, there is no M0 – metastasises).

    Also cancer can be classified by stages from the first to a tumor, the fourth depending on prevalence, in a wall and its metastasis.

    Gullet cancer symptoms

    Cancer of a gullet of early stages most often is not shown clinically, the symptomatology begins to be shown in the presence of already quite large tumor impeding progress of food. The most common symptom of cancer of gullet is disorder of swallowing – a dysphagy. Patients seek to eat liquid food, firmer gets stuck in a gullet, creating feeling of "lump" behind a breast.

    When progressing a tumor morbidity behind a breast, in a drink can be noted. Pain can give to an upper back. Decrease in passability of a gullet promotes developing of vomiting. As a rule, the long lack of food (connected with complicated meal) leads to the general dystrophy: to decrease in body weight, disorder of work of bodies and systems.

    Often cancer of a gullet is followed by constant dry cough (arises reflex as a result of irritation of a trachea), hoarseness (chronic laryngitis). At terminal stages of development of a tumor in vomiting and cough it is possible to find blood. All clinical displays of cancer of gullet are not specific, but demand the urgent address to the doctor. Regular dispensary observation from the gastroenterologist is demanded by the patients having Barret's disease as persons with high risk of development of cancer of gullet.

    Diagnosis of cancer of gullet

      ()As it is possible to call any new growth, a tumor of a gullet only malignant after carrying out a biopsy and identification of cancer cells. For visualization swelled up are applied: the X-ray analysis of lungs (sometimes it is possible to see formation of the centers of cancer in lungs and a sredosteniye), a contrast X-ray analysis with barium allows to find tumoral education on gullet walls. The endoscopic research (ezofagoskopiya) allows to examine in details an internal wall, mucous, to find a new growth, to investigate its size, a form, a surface, existence or lack of ulcerations, nekrotizirovanny sites, bleeding. At endoscopic ultrasonography it is possible to determine depth of germination of a tumor in a wall of a gullet and surrounding fabrics and bodies.

    Ultrasonography of an abdominal cavity gives information about existence of metastasises of cancer of gullet. MSKT and a magnetic and resonant tomography allows to receive detailed pictures of internals, to reveal changes of lymph nodes, bodies of a sredosteniye, a condition of vessels and adjacent fabrics. The Positron and Issue Tomography (PIT) supplements these researches, revealing malignant fabrics. At laboratory blood test presence of onkomarker is defined.

    Cancer therapy of a gullet

    Tactics of cancer therapy of a gullet depends on its localization, the size, extent of infiltration of a wall of a gullet and surrounding fabrics a tumor, existence or lack of metastasises in lymph nodes and other bodies, the general condition of an organism. As a rule, several experts take part in the choice of therapy: gastroenterologist, oncologist, surgeon, specialist in radiation therapy (radiologist). In most cases combine all three main techniques of treatment of malignant new growths: surgical removal of a tumor and the struck fabrics, radio-radiation therapy and chemotherapy.

    Surgical cancer therapy of a gullet consists in a resection of a part of a gullet with a tumor and adjacent fabrics, removal of the lymph nodes which are settling down a row. Then the remained site of a gullet is connected to a stomach. At the same time for plasticity of a gullet can use both tissue of the stomach, and an intestinal tube. If the tumor is not subject to full removal, then it is excised partially to release a gullet gleam.

    In the postoperative period patients eat parenterally, an opportunity to eat food in the usual way will not be restored yet. For the prevention of development of an infection in the postoperative period the patient appoint antibiotic treatment. For destruction of the remained malignant cages carrying out a course of radiation therapy is in addition possible.

    Radiation anticarcinogenic therapy consists in radiation of an affected area of a body the x-ray radiation of high intensity. There is an external radiation therapy (radiation is carried out from an external source to the area of a projection of the irradiated body) and internal radiotheraphy (radiation by the radioactive implants entered into an organism). Quite often radiation therapy becomes a choice technique at impossibility of implementation of surgical removal of a tumor.

    The chemotherapy at cancer of a gullet is applied as an auxiliary method of suppression of activity of cancer cells. The chemotherapy is carried out by means of strong cytotoxic medicines. Photodynamic therapy is shown to patients who cannot make surgical correction of a gleam of a gullet for the purpose of simplification of swallowing. This technique consists in maintaining in tumoral fabric of photosensitive substance then influence cancer the laser, destroying it. However it is impossible to achieve by means of this technique of elimination of a malignancy - it is palliative therapy. Upon termination of a course of antineoplastic treatment all patients surely are on the oncological account and regularly undergo comprehensive examination.

    Complications of cancer of gullet and its treatment

    The main complication of cancer of gullet is the weight loss resulting from the progressing dysphagy. Also there can be various alimentary frustration (alimentary dystrophy, hypovitaminosis) as a result of insufficiency of food. The malignant tumor can be complicated by accession of a bacterial infection. In addition, the tumor can and bleed.

    The chemotherapy often is followed by the expressed side effects: baldness (alopetion), nausea and vomiting, diarrhea, general weakness, headaches. Patients to whom photodynamic therapy was carried out have to avoid direct sunshine in the next months as their skin gains special light sensitivity.

    The forecast at gullet cancer

    Treatment of cancer of gullet is possible at early stages when malignant process is limited by a gullet wall. In such cases surgical excision of a tumor in combination with radio-radiation therapy gives very positive effect, there is every chance to an absolute recovery. When cancer is found already at a stage of metastasis and the tumor sprouts in deep layers, the forecast adverse, full treatment, as a rule, is impossible.

    In hard cases, senile age and at impossibility of full removal of a tumor apply palliative treatment to restoration of normal food. Survival of patients with not operated cancer of a gullet does not exceed 5%.

    Prevention of cancer of gullet

    Specific prevention of cancer of gullet does not exist. It is desirable to avoid smoking and abuse of alcohol, regularly to conduct examination of a digestive tract regarding the diseases which are precancer states, to watch the weight.

    In case of the available gastroezofagealny disease it is regular to conduct endoscopic examination. The annual biopsy is shown to patients with Barret's gullet.

    Gullet cancer - treatment

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